支气管镜下电凝治疗气道内增生性病变12例临床分析  

The technique of electric coagulation through the flexible bronchoscope for resecting central airway constriction in 12 children

作　　者：倪彩云[1] 刘霞[1] 王少超[2] 马静[1] 张忠晓[1] 闫秀丽[1] 牛铁环[1] 韩晓蓉[1] 孟晨[1] 

机构地区：[1]山东大学齐鲁儿童医院呼吸介入科,山东济南250022 [2]山东大学齐鲁儿童医院麻醉科,山东济南250022

出　　处：《中国实用儿科杂志》2013年第3期204-206,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨支气管镜下电凝治疗儿科气道管腔内肉芽形成、纤维组织增生导致气道狭窄及咽喉部占位性病变压迫气道引起通气不畅的疗效和安全性。方法对2009年9月至2011年6月山东大学齐鲁儿童医院呼吸介入科收治的12例气道内增生病变患儿,其中支气管异物后气道内增生3例、支气管内膜结核菌感染引起黏膜肉芽生长阻塞气道所致肺不张2例、气管插管后气管黏膜纤维组织增生导致气管狭窄出现呼吸困难5例、舌根部囊肿压迫会厌致会厌抬起受限而引起呼吸困难2例。实施支气管镜下电凝治疗。分别于术前和最后1次电凝治疗后对病变部位进行支气管镜下评估,胸部CT及肺功能检查,对肺不张及通气功能进行评价。结果 12例患儿分别接受电凝治疗(共13次),其中显效11例、有效1例,有效率100%,未见并发症发生。结论支气管镜下电凝治疗对于异物、感染后肉芽组织生长阻塞气道形成的肺不张、气管插管后气道内膜纤维组织增生性气管狭窄以及咽喉部占位性病变压迫气道形成的呼吸困难,是快速、有效的治疗方法,但手术操作有风险,需经技术培训。Objective To explore the efficacy and safety of electric coagulation through the flexible bronchoscope in the treatment of the central airway constriction caused by the formation of granulation tissue and fibroplasia and the ventilation obstruction compelled by the occupying diseases of throat in children.Method Twelve cases were treated using the electric coagulation through the flexible bronchoscope. Those cases included 3 cases blocked by bronchial foreign body, 2 cases with atelectasis due to the formation of granulation tissue after endobronchial tuberculosis, 5 cases who had decompensation caused by the gas channel fibroplasia after the trachea cannula and 2 cases of dyspnea caused by cysts in root of the tongue.The effect evaluation was performed before the operation and after the last electric coagulation.The size of the airway constriction was evaluated by bronchoscope and the degree of atelectasis and respiratory ventilation were separately estimatede by computer tomography and pulmonary function test.Result Twelve patients seperately received electric coagulation procedures, 11 patients had excellent treatment effect, and one with effective effect.The rate of effective therapy was 100%. No complications happened.Conclusion The method of electric coagulation through the flexible bronehoscope for central airway obstruction caused by granulation, fibroplasia and the occupying diseases of throat is effective and convenient. However, the method has certain operation risk, so operators should be specially trained.

关 键 词：气道狭窄 儿科 电凝治疗 支气管镜 

分 类 号：R72[医药卫生—儿科]